“Health problems for women start even before birth. Advanced biomedical techniques allow in utero sex determination which could result in termination of the female fetus. The birth of a girl is heralded as a bad omen. As a child, she is poorly nourished, because she, like her mother, is restricted to food left over from the men’s meals. She is given fewer opportunities for schooling. Then comes early marriage, coupled with all the risks of teenage pregnancy. As the village health workers discussed each topic, the relationship between women’s status and health became apparent. They also realized how much their own lives had been affected by the social pressures and norms imposed on them.” (Arole, Mabel & Arole, Rajanikant. Jamkhed: A Comprehensive Rural Health Project. Pune: 1994.)

Four women observing glucose testing during diabetes project

Women’s unequal treatment and access to healthcare is a worldwide issue that can be seen in any part of the world. In India, female feticide is one of the large problems concerning female inequity in health. Though knowing the sex of a baby before birth is illegal in India in response to the female feticide epidemic, healthcare facilities can often still be paid off for sonograms. If the child is a girl, she is at a huge risk for abortion, and this decision is more often made by the woman’s mother-in-law or the husband than the woman carrying the child. Often, the woman carrying the child has little to no choice in regard to her own reproductive health. There have also been many cases of female infanticide. Once a girl child has been born, a family might decide to kill her, because she is viewed as a burden that the family does not wish to have. This is one of the large reasons that the large majority of India has such an uneven male to female ratio. However, it is important to remember how highly diverse India is, and that in some places, such as Kerala (a southern state in India with a matrilineal society), there is a more even sex ratio with slightly more women than men.

We met a survivor of a female infanticide attempt in the slum Indiranagar located immediately outside of the CRHP campus. Her father no longer wanted her, so he hit her head with large blows attempting to kill her. The girl survived and was taken in to be cared for by her aunt. When the teacher, Meena, from the Joyful Learning Preschool run by CRHP found her, she insisted that the girl attend the school. Special needs children in rural Maharasthra are often not well cared for due to a lack of awareness and knowledge of how to care for them, so it was not surprising that she still suffered from much neglect and was often found engaging in unhealthy activities, such as playing with and eating mud. The girl used to be unresponsive, and they assumed that she was both deaf and dumb. However, since her time at the preschool, she has become very responsive. Though she still does not talk, she has proven that she can hear through her responses. The other interns and I loved having the opportunity to meet her and interact with her during preschool. (On days off from our projects, some of us go to the preschool for the morning preschool pick-up walks or to play with the children during activity time.) She has a wonderful smile and loves to give high fives to everyone. Though she is now past the age of the other preschoolers, the primary schools refused to teach her, so Joyful Learning Preschool still happily welcomes her to help her continue to grow and develop healthily.

The Joyful Learning Preschool encourages children to practice healthy habits in sanitation, grooming, and eating while simultaneously helping children from Indiranagar receive an education that they likely would otherwise not receive. All students are provided with two meals per day and learn through a Montessori education. At first children from different castes would not interact, and boys expected the girls to feed them during meals. Now, they all hold hands together when Meena walks through the slums in the morning to pick them up to bring them to the school. Both the boys and girls serve each other at the preschool. Caste and gender barriers have been largely overcome at an extremely young age due to this program. Every year, 100% of the students graduating go on to primary school, and 75% of students go on to secondary school after that. The preschoolers often go home and teach their families of the healthy practices that they learned in preschool and are able to impact their whole community through this. Meena also does daily health checkups with the families when she picks up the children.

Playing at Joyful Learning Preschool

Playing at Joyful Learning Preschool

Shireen (an intern) holding hands with a student during preschool pickup

I am so grateful to have the opportunity to be at CRHP interning this summer. As I stated in my first blog, I found CRHP through my semester with School for International Training’s program in Public Health, Gender, and Community Action. I partook in a weeklong workshop at CRHP, where I fell in love with the organization and yearned to return. I made contact with one of the directors, Ravi Arole (the son of Drs. Mabelle and Raj Arole who founded CRHP), and Lexi Barab, the international intern coordinator, during the winter of my return to the United States requesting to return to intern. Through Dickinson’s Internship Grant, this internship was possible. I am so thankful for this opportunity and am learning so much! I get to participate in the diabetes project and learn from the incredible Mobile Health Team that leads it, but I also get to go to the Joyful Learning Preschool and talk to the amazing staff and other interns on campus during my free time.

The diabetes project has been going really well. Some days there have been almost 50 people in attendance for both lessons and receiving glucose tests. The number of women varies. Often, there are unfortunately much fewer women in attendance than men. However, it is hopeful that the men return to their families and educate them on what they learned at the lessons.

Two women having blood sugar tested by Asha and Madumama (mobile health team members)

Diabetes Project lessons

Diabetes project glucose testing

Ratna passing out bananas to the village preschoolers that attended the diabetes project lesson. Puppet skits and songs are performed to engage children who attend the lessons.

Asha, Ratna, and Sureka giving diabetes lesson (One woman sits in the back on the wall in the upper right corner)

Ratna and Madumama teaching diabetes lesson